Understanding Phantom Pregnancy: When the Body Believes, but There's No Baby

Some of us will have had moments where we thought we were pregnant when we actually weren’t. Maybe your period was a few days late, and you just had “that feeling” that pregnancy was underway.

You may have even had some signs of early pregnancy, such as nausea or sore breasts.

Usually, though, your suspicions (or hopes) are easily answered by the coming of your period or a negative pregnancy test. This sort of thing is common for most women to experience a few times in their childbearing years: a hunch that they are pregnant—and maybe even a few light pregnancy symptoms—only to find out it wasn’t true.

But, there is another phenomenon where a woman experiences the signs of symptoms of pregnancy in a much more pronounced way, with sometimes obvious, pronounced physical signs of pregnancy, including missed periods, a growing abdomen, and even baby kicks.

Known officially as pseudocyesis, (from the Greek ‘pseudes’ meaning false, and ‘kyesis’ meaning pregnant) a phantom or false pregnancy is when a woman believes she's pregnant even though she isn’t. The phenomenon is quite rare, but for women who are experiencing it, it’s quite real … real in the sense that they feel psychologically pregnant and may even manifest some physical symptoms, but there is no actual baby growing, no positive pregnancy test, no fetal heartbeat and no ultrasound confirmation.

What is a phantom pregnancy?

Pseudocyesis is different from a mental health disorder characterized by delusions of pregnancy, as may be found in a person suffering from schizophrenia or psychosis.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) describes pseudocyesis as: “A false belief of being pregnant that is associated with objective signs and reported symptoms of pregnancy, which may include abdominal enlargement, reduced menstrual flow, amenorrhea, subjective sensation of fetal movement, nausea, breast engorgement and secretions, and labor pains at the expected date of delivery”.

In other words, a person who suffers from pseudocyesis not only believes they are pregnant, but they also actually exhibit physical signs of pregnancy.

Symptoms of a phantom pregnancy

Women experiencing a phantom pregnancy may have many or even all of the physical signs one would normally associate with pregnancy, including:

• Lack of a period

• Breast tenderness and enlargement

• Abdominal enlargement

• Nausea

• Vomiting

• Weight gain

• Urinary frequency

• Food cravings

• A sensation of fetal movement

In some cases, a woman experiencing a phantom pregnancy may have elevated levels of estrogen or prolactin, which may be the reason behind some of the physical symptoms, as well as the psychological symptoms (such as the desire to bond with a baby) of a phantom pregnancy.

What's the difference between a phantom pregnancy and a real pregnancy?

While women with pseudocyesis report and possibly exhibit physical signs and symptoms of pregnancy, and they believe with everything they’ve got that they’re pregnant, a phantom pregnancy is missing one key component that is always there is a real pregnancy: a positive pregnancy test for the pregnancy hormone hCG (human chorionic gonadotropin). Although pregnancy tests do sometimes come back with false-negative results, a second negative blood pregnancy test proves that there is no pregnancy.

Causes of a phantom pregnancy

Let's take a look at what might be the cause of a phantom pregnancy? There are a few possibilities as to why this phenomenon occurs.

Experts are not totally sure what causes pseudocyesis. It is often thought of as a psychosomatic condition, where the belief or hope that you are pregnant causes your body to produce pregnancy symptoms. But in some cases, there are other medical conditions that may cause pregnancy symptoms to be experienced, such as:

• An intense desire to become pregnant after miscarriage or other pregnancy loss may cause a hormonal imbalance which causes pregnancy symptoms to appear

• Abdominal distention from other physical factors such as weight gain, gas, or tumors, in combination with psychological delusions of pregnancy

• Other physical and hormonal factors - such as pituitary tumors or ovarian/uterine cysts or growths - along with a desire to become pregnant

Factors that might make someone more likely to experience pseudocyesis include:

• A history of depression or mental illness

• A history of pregnancy loss

• A history of infertility

• History of trauma, sexual or spousal abuse

How Common Is Pseudocyesis?

Cases of phantom pregnancy have been recorded throughout history, most notably by Hippocrates, who documented 12 cases, and it is thought that Queen Mary Tudor also experienced two phantom pregnancies. The condition is more common in dogs and mice, with dogs suffering from ’pseudopregnancy’ whereby they attach themselves to cuddly toys as if they were puppies.

Today, phantom pregnancy is considered a very rare condition, with pseudo pregnancies affecting only one in six out of every 22,000 human births in the U.S. Africa has a higher prevalence, with 1 in every 160 women who experience infertility showing signs of pseudocyesis. Most instances of pseudocyesis occur in women of childbearing ages, between the ages of 20-44 years. Rarely, pseudocyesis occurs in men: this is called “sympathetic pregnancy” or couvade. Around 81% of people who experience phantom pregnancy are married or in a long-term relationship and it can happen more than once!

Helping a Loved One

It’s important to understand that pseudocyesis is a very complex issue. The person who is experiencing pseudocyesis usually has a strong belief that they are pregnant, and it can be hard to argue with someone who is actually experiencing symptoms of pregnancy.

When it is confirmed that what that person is experiencing is not an actual pregnancy, the grief that comes next may be intense. Sometimes it will be virtually impossible to convince someone who has experienced pseudocyesis that they are not pregnant.

If you are caring for a loved one who has experienced pseudocyesis, it’s important to be gentle. Very often, pseudocyesis stems from the trauma of having lost a pregnancy or having experienced infertility.

Caring for someone who has pseudocyesis must involve a strong element of compassion, and a delicate balance of validating that person’s feelings, and also acknowledging the facts of the situation.

Pseudocyesis is treatable and can resolve, but it may be painful for the person who is experiencing it as well as their loved ones. So be kind—and also encourage your loved one to seek professional help when the situation warrants it.

Have you experienced a phantom pregnancy?

If you thought you were pregnant, and experienced symptoms of pregnancy, only to find out that you were not pregnant, you may feel emotionally crushed. You may feel confused and numb. These are all normal reactions to this experience. You truly believed that what you were experiencing was pregnancy, and you may have been aching for a child. So you may be experiencing a profound sense of loss.

If you were diagnosed with pseudocyesis, you may not only feel upset by the reality that you are not pregnant but scared or ashamed that this happened to you. You may wonder what is wrong with you, and you may be afraid to seek the help that you need at this time.

There is nothing to be ashamed of. There are many reasons why you may have experienced this. Be sure to explore these reasons with your health care provider, and get whatever medical tests they suggest. If they recommend therapy, it’s important to follow through and make an appointment with a therapist or counselor. Your mental health is important, and you deserve compassionate care right now.